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What causes Plagiocephaly

Plagiocephaly can develop while the baby is in the womb (intrauterine) or  after delivery. One intrauterine cause is the lack of space during late stages of pregnancy. The baby’s head may be compressed at one side as a result of limited space, causing a relatively flatter skull on the pressured side. Thus, plagiocephaly is more common during the first pregnancy and multiple pregnancy.

Most plagiocephaly happens after delivery. In 1992, prone lying was identified as a factor that may cause Sudden Infant Death Syndrome (SIDS). As a result of SIDS prevention, parents position their baby on their back for play and sleep. This has successfully reduce SIDS incidence worldwide. However, this also caused many babies to developed pressured spot on their skull while lying on their back, resulting in development of plagiocephaly.

Plagiocephaly is also related to torticollis. Torticollis is a condition where  certain neck muscle is shortened, causing the head to rotate and/or side tilt. This preferential head rotation results in flattening of the skull on the pressured side. Infants with macrocephaly and/or low muscle tone (hypotonia) tend to develop plagiocephaly due to the lack muscle strength to rotate or control head movement. The flattened skull also encourage the child to lie on it even more as it is a position of comfort. As a result, the deformity is maintained.

Disclaimer: The information and advice contained in or made available through this website is for educational purposes only and is not intended to replace the services of a health professional or to be a substitute for medical advice of physicians.

Gross motor milestones 0-6 months

Newborn

A newborn’s movement is controlled mainly by reflexes. The reflexes include asymmetrical tonic neck reflex (ATNR), Moro, rooting, sucking and swallowing reflex.

Due to the position in womb over 40 weeks, a newborn adopts a fetal posture. In lying, the arms and leg are held close to the body. On the tummy, the infant head is turned to one side, the buttocks are humped up and knees are flexed under the abdomen.

3 months old

The primitive reflexes are gradually disappearing while the baby gains more control over their neck and shoulder muscles. When lying on the back, the baby has enough neck strength to hold the head in midline. During pull to sit, there is little or no head lag. The baby is also beginning to understand his body, able move all 4 limbs symmetrically, bringing hands to midline for finger play. When lying on tummy, the baby can lift head and upper chest well off the bed, weight-bearing on forearm with buttocks flat on bed.

6 months old

Over the months, the baby has developed enough trunk and abdomen strength to roll from front toback and back to front. When lying on the back, the baby can raise his head to look at feet and bring the feet to mouth for exploration. At 6 months, the baby start sitting with support, balancing himself with his hands. When held standing, the baby weight bear well on both feet and bounces up and down actively.

 

 


– 0-6 month gross motor milestones pamphlet format

Disclaimer: The information and advice contained in or made available through this website is for educational purposes only and is not intended to replace the services of a health professional/physiotherapist or to be a substitute for medical advice of physicians.
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